Families are a dynamic group of people where each person is an individual with their thoughts, feelings, and personalities. The family unit may be small, medium or large, but each person is equally important in the cohesiveness of the dynamic. However, families can be devastated by drug or alcohol addiction. When one family member is struggling with alcohol or drug abuse, it affects the entire group.

Here’s something to keep in mind: The federal National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that 10 percent of U.S. children live with a parent with alcohol problems. Also, as of 2018, the NIAAA states that 600,000 kids ages 12 to 17 have an alcohol use disorder. 

How Does Family Therapy Work?

Family therapy usually starts once the addicted person is well on their way and secure in recovery. This could be roughly weeks or months into treatment. The setting is generally in an office or meeting space and is led by a licensed family therapist, social worker, clergy member, or other mental health professional. The meeting facilitator should be respectful, non-judgmental, and sensitive to the family’s situation.

The therapy session lasts for about an hour. Participants might be asked to sign a contract stating the rules and guidelines for the meeting, such as not interrupting someone when they are talking. The meeting leader might ask each person some questions or might let the family talk to get a feel for how the family dynamic works.

The sessions are meant to learn what issues are facing the family and works to find the solutions. Therapy participants can learn new coping skills, new communication skills, and may get some “homework.” This could be removing anything from the home that can trigger the person with addiction. The facilitator might tell the family unit to do one activity together, like going for a walk and talking to each other, not at each other. One goal of family therapy is to maintain a safe space for each person to relay how they feel and what affects them.

This is where family therapy can be beneficial. The therapy session allows each family member to relay how they are affected by the addicted person’s use. Therapists spend time working with the family as a whole helping them find positive ways to work through addiction recovery.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published a guide, “Substance Abuse Treatment and Family Therapy,” which provides guidelines for family therapists about how family members and significant others can be increasingly valuable to the addicted person in recovery. 

The guide states, “Family therapy in substance abuse treatment can help by using the family’s strengths and resources to find ways for the person who abuses alcohol or drugs to live without substances of abuse and to ameliorate the impact of chemical dependency on both the patient and the family, according to SAMHSA. 

“Family therapy can help families become aware of their own needs and aid in the goal of keeping substance abuse from moving from one generation to another.”

Types of Families and how Addiction Affects Them

SAMHSA’s Treatment Improvement Protocol identifies different family groupsand how an addicted person affects them and how they can be beneficial in addiction recovery:

  • A client who lives alone or with a partner – In this situation both partners need help. If one is chemically dependent and the other is not, issues of co-dependence arise.
  • Clients who live with a spouse or partner and minor children – Most available data indicate that a parent’s drinking problem often has a detrimental effect on children. The spouse of the person abusing substances is likely to protect the children and assume the parenting duties of the parent abusing substances. The effect on children is worse if both parents abuse alcohol or drugs.
  • A client who is part of a blended family – Stepfamilies present special challenges and substance abuse can become an impediment to a step family’s integration and stability.
  • An older client with grown children – Additional family resources may be needed to treat the older adult’s substance use disorder. There may be issues of elder maltreatment that must be reported to local authorities.
  • An adolescent substance abuser living with his or her family of origin – Siblings in the family may find their needs and concerns ignored while their parents react to the continuous crises involving the adolescent who abuses alcohol or drugs. If there is a parent who also abuses substances, this can set in motion a combination of physical and emotional problems that can be very dangerous.
  • Foster children – Sometimes, foster parents will get an older child who has a substance abuse problem. Therapy is a good resource for these “temporary” families and might even be a catalyst of change for the foster child. It’s certainly something to look into if you find yourself in this situation.
  • Friends – Friends of an addicted person can provide insight on personality, past and present behavior, and behavior changes due to addiction. Friends can also offer strong support throughout addiction recovery.


Benefits of Family Therapy in Addiction Recovery

There is no doubt that the family’s role in addiction recovery is paramount to the affected person’s treatment and sustained sobriety. Everyone has been affected in some way, and everyone should learn how to convey how the addiction governs the way they react to the person in treatment.  It is often difficult to answer questions without feeling or speaking defensively when that is all you have felt for a long time. Family therapists offer the communications tools that can guide you in the most effective methods of relaying how you feel and what you want.

Many times, some family members will engage in enabling behavior, such as cleaning up the mess of a person addicted to alcohol, paying bail money to get a child out of jail who was arrested on drug charges or making excuses for the addicted one. When this happens, other family members may think that it’s OK to do the same thing. Enabling someone who is addicted is aiding them in obtaining and using the drug or alcohol. This is harmful to everyone. Family therapy can help each person find their voice in a constructive way.

Family Therapy is Evidence-Based Treatment

What does evidence-based treatment mean? This term and the often mentioned “evidence-based therapies,” are treatments and therapies which are backed by scientific research and studies. They are considered the best options when seeking family support programs for substance abuse because they have been proven to work.

Information collected and reported relays how valuable family therapy is to an addicted person’s recovery. “Success will depend on many variables, but the variable you can control as a family member is recognition of the problem and willingness to seek a solution.”

The National Institute on Drug Abuse (NIDA) states that the family’s role in addiction recovery is essential to the success of the addicted family member or spouse’s treatment.

Addiction was once thought to be the trait of morally lacking people. Today, that thought isn’t true with more research-based proof that it is a chronic disease of the brain that is treatable. Every family member and spouse are vital in the treatment and recovery of an addicted family member. The African proverb that “it takes a village to raise a child” rings true, as “the village” consists of every person who loves and care for each other in a family unit–no matter how you define family.

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